J Trauma
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While the technique of early excision and grafting has many advantages in the treatment of thermal injuries, it is not without significant complications. Hemorrhage accompanying burn wound excision can be deceptively great, as can the metabolic stress of large surgical procedures performed in the postburn period. In an effort to minimize these complications, we have developed a two-stage technique for excision and grafting of burn wounds. ⋯ Temperature decrease during surgery was also great, with significant hypothermia occurring in 51% of procedures exceeding 2 hours in length. We conclude that performing excision and grafting in two stages limits hemorrhage and heat loss from each individual surgery, thereby permitting the performance of larger procedures. Nonetheless, continued awareness of the magnitude of these complications remains an essential of successful excisional therapy.